Diverticulosis is a common colonic condition in elderly patients of the Western world, with a prevalence of 37 to 45%. Although diverticula more commonly occur on the left side of the colon, bleeding usually originates from right-sided lesions. It is estimated that hemorrhage occurs in 3 to 5% of all patients with diverticulosis. Due to the high prevalence in the general population, and particularly the elderly, it is the most common cause of lower GI bleeding, accounting for over 30% of cases. Diverticular bleeding usually presents as painless, large-volume hematochezia of abrupt onset; bleeding ceases spontaneously in up to 90% of patients. Rebleeding occurs 22 to 38% of the time, and the likelihood of a third bleeding episode in such

TABLE 101-1. Etiology of Colonic Bleeding

Diverticulosis Angiodysplasia Cancer/Polyps Inflammatory bowel disease Radiation proctocolitis Infectious colitis Ischemic colitis Anorectal disease Hemorrhoids Anal fissures Rectal ulcers Fistula in ano Rare Causes Portal hypertensive colopathy Small bowel varices Colonic and rectal varices Endometriosis

Dieulafoy's lesion of the colon NSAID-induced colonic ulcers Vasculitis

Aortocolonic fistula

Acute graft-versus-host disease

NSAID = nonsteroidal anti-inflammatory.

patients is approximately 50%. This has led some experts to recommend surgical resection of the involved section of colon after a second bleeding event.

Managing Diverticular Disease

Managing Diverticular Disease

Stop The Pain. Manage Your Diverticular Disease And Live A Pain Free Life. No Pain, No Fear, Full Control Normal Life Again. Diverticular Disease can stop you from doing all the things you love. Seeing friends, playing with the kids... even trying to watch your favorite television shows.

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